Has it happened that you have been affected by winter vomiting disease at your ?

This article is written from a Swedish perspective, but hopefully it can inspire people from other countries.

Every winter a number of nursing homes are affected by winter vomiting disease, calicivirus. Once it has entered the premises, the operation needs to establish cohort care to reduce the risk of further spread. It is important to have good routines for both hygiene and food handling to reduce the risk of being affected. Likewise, there need to be routines to establish cohort care even during on-call hours.

Foto: Mostphotos

Winter illness is something that recurrently affects society and thus also nursing homes. This story is about a residence where winter vomiting disease affected many of the residents and it spread between the floors of the residence. Nurses and the unit manager worked hard for the staff to understand the importance of following hygiene routines and after a while, they got the outbreak under control.

After a few weeks, the winter illness broke out again and now a hygiene nurse was involved to help create a safe working method. It then emerged that employees had frozen leftover food in connection with the first outbreak and when this food was now served again, the winter vomiting disease also returned.

This residence and many others have learned the hard way the importance of following hygiene routines. For the elderly who are affected by winter vomiting disease, it can mean an early demise.

Always contact a nurse

There are therefore rules for how the staff should be dressed and handle their own hygiene. There also need to be routines for how the operation should work with this during on-call time.
To reduce the risk of more people being affected, the operation must take a number of measures. It is important to introduce secluded care (cohort care) for those who are infected. Special staff are set aside to work with the infected. These are not allowed to work with residents who are not infected. Hygiene routines are always important but here it is extra important to use both soap and water as well as hand sanitizer.
It may also be valuable to inform relatives so that they do not make unnecessary visits to the unit, and thus risk being infected. Many times, the operation puts up signs indicating that there is an infection in the nursing home.

Incubation period for winter vomiting disease

Winter vomiting disease is very contagious and the time from getting infected to falling ill is usually between 12-48 hours. In addition to becoming nauseous, vomiting and having diarrhea, one can suffer from headaches, fever and stomach pain. You usually recover within 1-3 days.

Can you be immune to winter vomiting disease?

Approximately 20% of all people in Sweden are immune to winter vomiting disease.

Care during winter vomiting disease

Those who have fever and vomiting may need extra to drink to avoid dehydration. It's not that easy to get in when you feel at your worst. Always contact a nurse for an assessment of the risks. Fever can be mitigated with paracetamol and for those who have a fever it can be nice to be dabbed with a towel lightly dipped in lukewarm water.

Care staff:
- What can you do to be prepared when the winter vomiting disease comes?
- How do you handle colleagues who you notice are lacking when it comes to hygiene routines?
- How do you handle leftover food? Are there routines to always contact a nurse for diarrhea or vomiting?

Manager, nurse, occupational therapist and physiotherapist:
- What can you do to have a preparedness when the winter vomiting disease comes to you?
- Do you have recurring self-control of hygiene routines?
- How is leftover food handled? Are there routines for cohort care?

Residents and relatives:
- Has your nursing home been affected by winter vomiting disease?
- Was it handled in a good way?

Erland Olsson
Specialist Nurse
Quality in Elderly Care

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